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STOPS Trial: Total vs Subtotal Colectomy for Slow Transit Constipation
Sponsor: Third Military Medical University
Summary
Total colectomy with ileorectal anastomosis is a traditional surgical option for slow transit constipation (STC). Subtotal colectomy with caecorectal anastomosis have been reported to be a potential alternative approach. Thus, the optimal surgical option for STC is controversial.
Official title: STOPS Trial: A Multicentre Prospective Randomised Clinical Trial Comparing Total Colectomy With Ileorectal Anastomosis Versus Subtotal Colectomy With Cecal-rectal Anastomosis for Slow Transit Constipation
Key Details
Gender
All
Age Range
18 Years - 80 Years
Study Type
INTERVENTIONAL
Enrollment
252
Start Date
2022-03-27
Completion Date
2028-12-31
Last Updated
2025-03-21
Healthy Volunteers
No
Conditions
Interventions
Total colectomy with ileorectal anastomosis
Following complete colonic mobilization without preservation of the ileocolic vascular pedicle, the surgical specimen was extracted by extending the right lower quadrant trocar incision to approximately 4-5 cm. A resection of ileum, 2-3 cm proximal to the ileocecal junction, will be conducted by stapler. The anvil of a 29-mm circular stapler was inserted into the proximal ileal lumen and repositioned intra-abdominally. Ileorectal anastomosis was performed by transanal insertion of the circular stapler, aiming to achieve a tension-free, contamination-minimized reconstruction. Finally, a closed suction drain was placed in the rectouterine pouch (Douglas pouch), and all abdominal incisions were closed in layers.
Subtotal colectomy with cecal-rectal anastomosis
Following complete colonic mobilization with preservation of the ileocolic vascular pedicle and its branches, the surgical specimen was extracted by extending the right lower quadrant trocar incision to 4-5 cm. After insertion of the anvil from a 29-mm circular stapler through the ascending colon resection margin, a resection about 3 cm distal to the ileocecal junction will be conducted. The cecum was then positioned in the pelvis without rotational torsion, and an antiperistaltic cecorectal anastomosis was created between cecal fundus (after appendectomy) and the rectal stump. The anastomosis was performed via transanal insertion of the circular stapler to ensure tension-free, contamination-controlled reconstruction. Finally, a closed suction drain was placed in the rectouterine pouch (Douglas pouch), and all abdominal incisions were closed in a layered fashion.
Locations (16)
Army Medical Center (Daping Hospital)
Yuzhong, Chongqing Municipality, China
No. 940 Hospital of Joint Logistics Support Force of Chinese People's Liberation Army
Lanzhou, Gansu, China
The People's Hospital of Guangxi Zhuang Autonomous Region
Nanning, Guangxi, China
The First Affiliated Hospital of Harbin Medical University
Harbin, Heilongjiang, China
Renmin Hospital of Wuhan University
Wuhan, Hubei, China
Zhongnan Hospital of Wuhan University
Wuhan, Hubei, China
General Hospital of the Eastern Theater Cammand of the PLA
Nanjing, Jiangsu, China
The First Hospital of China Medical University
Shengyang, Liaoning, China
Qingdao Municipal Hospital
Qingdao, Shandong, China
Renji Hospital, Shanghai Jiaotong University
Pudong, Shanghai Municipality, China
Shanghai Pudong New Area People's Hospital
Pudong, Shanghai Municipality, China
Xijing Hospital
Xi’an, Shanxi, China
Chengdu Analrectal Hospital
Chengdu, Sichuan, China
The General Hospital of Western Theater Command
Chengdu, Sichuan, China
The Second People's Hospital of Yibin
Yibin, Sichuan, China
Zhejiang Provincial People's Hospital
Hangzhou, Zhejiang, China